OBJECTIVES: To explore the variation in the spatial distribution of notified dengue cases in Colombia from January 2007 to December 2010 and examine associations between the disease and selected environmental risk factors. METHODS: Data on the number of notified dengue cases in Colombia were obtained from the National Institute of Health (Instituto Nacional de Salud - INS) for the period 1 January 2007 through 31 December 2010. Data on environmental factors were collected from the Worldclim website. A Bayesian spatio-temporal conditional autoregressive model was used to quantify the relationship between monthly dengue cases and temperature, precipitation and elevation. RESULTS: Monthly dengue counts decreased by 18% (95% credible interval (CrI): 17-19%) in 2008 and increased by 30% (95% CrI: 28-31%) and 326% (95% CrI: 322-331%) in 2009 and 2010, respectively, compared to 2007. Additionally, there was a significant, nonlinear effect of monthly average precipitation. CONCLUSIONS: The results highlight the role of environmental risk factors in determining the spatial of dengue and show how these factors can be used to develop and refine preventive approaches for dengue in Colombia.